Active NPI
James Petersen, PHARMD
- Pharmacist
- Mesa, AZ
National Provider Identifier
1205136157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16314
- Practice address
- 9101 E Baseline Rd
Mesa, AZ 85209-7758 - Phone
- (480) 281-0180
- Fax
- (480) 281-0165
- NPI assigned
- Oct 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16314 | AZ | Primary |
Addresses
Primary practice location
9101 E Baseline Rd
Mesa, AZ 85209-7758
Mailing address
9101 E Baseline Rd.
Mesa, AZ 85208-6752
Phone (480) 281-0180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16314 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
-
- Community/Retail Pharmacy
- Mesa, AZ
- NPI 1962431932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1205136157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9101 E BASELINE RD.",
"city": "MESA",
"state": "AZ",
"postal_code": "852086752",
"telephone_number": "480-281-0180",
"fax_number": "480-281-0165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9101 E BASELINE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852097758",
"telephone_number": "480-281-0180",
"fax_number": "480-281-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "JAMES",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-26",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "16314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.